EVER since the introduction of Gesy a month ago, we have been hearing or reading about how the people “embraced” the health scheme. There was not a hint of exaggeration in this assertion, the only concern being that they embraced it so tightly they may have put it in danger of suffocating.
Reports that have followed suggested that too many people were abusing Gesy, suddenly everyone demanding their GP sent them for medical tests such as blood tests, MRI and CT scans. One GP said that while he had suggested these tests to patients in the past, they did not have them while “now they want to do it all in one day”. He had turned into an executioner of patients’ demands instead of a doctor, he complained on Facebook.
A senior official at the Health Insurance Organisation (HIO), which administers Gesy, told this paper that doctors, clinical labs and pharmacies were inundated with patients in the first three weeks of the scheme. “Everyone rushed to have their medical and lab tests which they were neglecting in the past and to arrange drug prescriptions,” she said. This was inevitable, considering universal free healthcare was something completely new to Cyprus and people are eager to reap its benefits.
The culture of how one acts as a beneficiary of such a scheme did not exist and had to be developed, the official said. This is an explanation for the abuse of the system, but there is also an economic explanation. When a service or good is free of charge, demand will always far exceed the supply. In the case of goods there are big shortages while for a free service, like healthcare, very long waiting lists are created that could undermine, if not destroy the operation of the system.
It could be argued that Gesy is not, strictly speaking, a free service as every working person pays into the system every month. But this makes things worse because a patient is even more demanding, unwilling to tolerate long waiting times to see a doctor. For the monthly rate paid, an individual is entitled to unlimited care and expects to be able to see be their doctor immediately and be referred for medical tests promptly, even when the doctor sees no need for them. This is guaranteed to put the system under strain, both operationally and financially, even if a limit has been put on the number of visits to a personal doctor a patient can make in a year.
Will the abuses of the system decline with the passing of time and the wearing off of the novelty of free healthcare? The HIO official said the culture should change, but how long will this take? How many campaigns? For how many years will it be necessary to stop people visiting a doctor because they have a headache and demanding they are referred for an MRI scan? People now believe they are entitled to everything Gesy has to offer, even if they do not need it.
It might not be a very popular idea, but the only way to stop the abuses that are certain to clog up the system and damage the quality of the service would be the introduction of small charge – €5 perhaps – for every visit to a doctor and for medical tests. It worked at the A&E departments at the hospitals, where people would turn up to have their blood pressure measured. After the introduction of a small fee, visits fell by 50 per cent, freeing hospital staff to deal with urgent cases.
The same measure could be introduced to Gesy to ensure against abuses, thus reducing the waiting times for people in real need of care and keeping the costs of the scheme under control. Excessive numbers of blood tests and MRI scans would substantially increase costs, which is the number one concern. Both the IMF and European Commission warned about the risks posed by Gesy to fiscal stability. This is why the excess demand for healthcare needs to be addressed now with practical measures.